Surgical outcomes of carotid body tumors removal and analysis of cardinal predictors associated with neurovascular and bleeding complications

Abstract

BACKGROUND: Improvement of existing forecasting tools for prediction of neurovascular and bleeding complications associated with carotid body tumors (CBTs) surgery and construction of novel predictive systems.METHODS: Medical records of patients who underwent CBT excision from 2011 to 2021 were retrospectively reviewed for perioperative information. The retrospective analysis was combined with confirmational prospective telephone survey of each patient for improvement of collected descriptive data quality.RESULTS: A total of 58 tumors were removed per 55 excisions. According to Shamblin’s classification, 34.5% of removed CBTs referred to grade I, 60% were grade II and only 5.5% belonged to grade III. The median tumor volume was 14.8 cm3 (interquartile range [IQR] 8.1-24.5 cm3). The mean distance from tumor apex to the base of skull (DTBOS) was 4.1±1.4 cm. The median estimated blood loss (EBL) was 200 mL (IQR 50-400 mL). The overall 30-day cranial nerve (CN) dysfunction rate after surgery was 60%. The overall 30-day mortality and 30-day stroke rate were 0% and 1.8%, respectively. The regression analysis revealed statistically significant (P<0.001) association between tumor volume and EBL with explicit positive linear trend (y = 76.95 + 9.22 x) and acceptable predictive strength (R2=0.368). Obvious negative correlation (P<0.001, R2=0.225) was discovered between tumor distance to base of skull (DTBOS) and overall amount of damaged CNs.CONCLUSIONS: Approximately 37% of differences in EBL can be explained by the differences in tumor volume. Approximately 23% of differences in overall amount of damaged CNs can be explained by the differences in DTBOS.